Provider Demographics
NPI:1477307015
Name:WISDOM ADULT DAY PARTNERS, LLC.
Entity Type:Organization
Organization Name:WISDOM ADULT DAY PARTNERS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SILLARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-917-2005
Mailing Address - Street 1:365 E AVENIDA DE LOS ARBOLES # 1025
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-2975
Mailing Address - Country:US
Mailing Address - Phone:818-613-5446
Mailing Address - Fax:
Practice Address - Street 1:2255 S DEPOT ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1216
Practice Address - Country:US
Practice Address - Phone:805-345-5224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage